Deaths and maiming are the norm as snakes ravage kitui and Lower Eastern (Kenya) – via Herp Digest

by Joe Ombour, 9/22/19 Standardmedia.com

The Mui River Basin in Mwingi Sub County, Kitui County is better known for its unexploited coal deposits. But this fertile basin, like most of the rain-starved Lower Eastern region, abounds in snakes.

The serpents with deadly fangs virtually rule the singed surface where temperatures favour their proliferation.

While natives do not eat them as happens in faraway China, belief has it that ill-intentioned folks use them to kill or maim their brethren. Wait! How is that possible? Father of nine Muasya Manzi says his daughter is a case in point.

“I wish snakes would talk,” muses Mr Manzi. “They would tell you exactly how it happens because the people who do it cannot go public. But I have no doubt in my mind that the snake that bit my daughter, a black mamba was sent by our enemy. It happens a lot here.”

He says he has killed 15 snakes in his bush ringed homestead hugging Mui Shopping Centre in the four years he has lived there, without a single case of snakebite. “How come my daughter was bitten in her sleep in a well-lit, well-plastered room at the shopping centre? I see a person’s hand in it,” he says.

His daughter, mother of four Lena Mwikali was asleep when she was bitten by a snake two years ago. She recounts: “I used to lodge in a room at Mui shopping centre and regularly walked from here after supper to spend the night there. I shared the room with another woman and we slept on a mattress on the floor.”

“We covered ourselves and slept after switching off the light on a fateful night, only to be awakened by sharp pain around 1 am. Something had pricked me on the elbow. I told my roommate to switch on the light upon which we saw a snake lying at the edge of the mattress parallel to the wall. We shouted and people came. They killed the snake and rushed me to a clinic where I was given some injections.”

Lena was the following day rushed to Mwingi where celebrated snakebite therapist Peter Musyoka saved her life with anti-venom neutralisers.

Kathini Mulyungi was not lucky when she was bitten by a black-necked cobra 22 years ago, aged only seven. She lost her right arm. “I was in Class Two at Mwingi Primary School,” she recalls, sadness permeating her face. ”I had just retired to bed that I shared with a niece when I was bitten in the wrist.”

“I have rushed to Mwingi Level Four hospital about four kilometres away, where anti-snakebite serum was out of stock. After first aid, I was put on strong painkillers for three months before I was transferred to the provincial hospital in Embu.

Kathini says her arm had developed gangrene, prompting doctors in Embu to amputate it to save her life. “I remained in hospital for one and a half months as my arm healed. Treatment cost Sh100,000 that my parents paid after selling livestock.”

She returned to school and sat the KCPE in 2005. Now a single mother of one, Kathini did not proceed to secondary school for lack of fees. She owns two donkeys and sells water in Mwingi town for a living. Benedict Kandali Mukengei, 25, was resting under a tree after labouring in the farm when he felt something heavy and cold land on his neck with a thud.

“It was a puff udder that quickly coiled itself around my neck after falling from the tree under which I was resting,” he narrates. Frightened to the bone, Mukengei stood and struggled to uncoil the serpent from his neck.

“I saw and smelt death. I cried loudly as I struggled with the snake that bit me in the back before it fell to the ground and slithered away into the bushes.”

“People from nearby homes who heard my distress call came and gave me raw eggs to swallow before they carried me home because I was feeling dizzy and could not walk.”

Mukengei says Good Samaritans used his phone to call Mr Musyoka who arrived promptly from his clinic in Mwingi, 15km away.

“I was still conscious, thanks to the raw eggs. Musyoka gave me two injections and a glass of water after every 10 minutes. I urinated and started feeling better,” he recounts. Today, Mukengei is a Boda Boda rider in Mwingi town.

Victims of snake bites in Mwingi and other areas within the Lower Eastern region have lost their lives for lack of immediate and appropriate attention.

Kamengele Mueni, a blind grandmother from Muumoni area north of Mwingi went to sleep unaware that a black-necked cobra had taken refuge in her bed, narrates her granddaughter, Roselyn Nduko. She died after she was bitten by the snake.

Snakebites Hit Record Highs in Southern States as Suburbs Expand Rapid urbanization and heavy rains lead to more copperhead attacks -via Herp Digest

By Valerie Bauerlein, 8/519, Wall Street Journal

RALEIGH, N.C.—Venomous snakebites are on the rise in the Sunbelt this summer, with North Carolina, Georgia and Texas on track to set records. 

In North Carolina and Georgia, venomous snakebites have been rising for the past several years and are up more than 10% from a year ago, according to the states’ poison-control centers. In Texas, there were 415 reported snakebites in May and June, 27% more than the same period five years ago.

Copperheads represent the vast majority of bites in the three states, and most are in fast-growing suburbs of cities like Raleigh, Atlanta and Dallas. Reasons for the increase include rapid urbanization, as new neighborhoods spring up in what was formerly forest or farmland, and last winter’s record-setting rainfall, which drives snake activity, poison-control workers said.

“There’s no question as we build out more, we’re definitely inhabiting the areas where snakes reside,” said Gaylord Lopez, the managing director of the Georgia Poison Center.

Snakebites take place nationwide, but North Carolina, Georgia, Texas and Florida represent a disproportionate 39% of the reported bites, according to a 2016 study of pediatric snakebites led by a University of Louisville epidemiologist. 

Copperheads are the dominant snake in all those states except for Florida, where snakebite activity has been average so far this year, according to Florida’s Poison Control Centers. Florida’s dominant snakes include the eastern coral snake and the cottonmouth.

Copperheads thrive in suburban environments because they have relatively small roaming areas, a strong homing instinct and a willingness to eat “whatever’s available,” from rodents to cicadas, said Jeffrey Beane, herpetology collections manager at the North Carolina Museum of Natural Sciences.

Copperheads also camouflage themselves easily in underbrush or leaf piles with their tan scales and brown triangular markings, he said.

A copperhead recently bit David Weitz, a Raleigh optometrist, as he transplanted rosemary from a flat to a pot at his newly built home on the outskirts of the city. Dr. Weitz, who grew up in Virginia Beach, said he knew enough about snakes to wear gloves but had taken them off to handle the small plants. He said his hand swelled to twice its size, and he was hospitalized for two days while being treated with antivenom.When Dr. Weitz recovered, he said he snake-proofed his 2-acre yard by clearing out underbrush and removing dead logs. “When I walk around my yard, I have a stick with me,” he said. “I hit the ground with it so they scatter.”

Many people who grow up in the Southeast learn to recognize copperheads by their “Hershey Kiss” markings. But in North Carolina, nearly half of the adults were born somewhere else, according to the Census.

Michael Beuhler, an emergency-room toxicologist in Charlotte and the medical director of the Carolinas Poison Center said many of his snakebite patients moved from the Northeast and Midwest where snakes are less common.

“They don’t realize that snakes are part of the environment,” Dr. Beuhler said. “They’re part of the circle of life here.”

Wet winters tend to drive snake activity, according to Grant Lipman, an emergency-room doctor at Stanford University who conducted a 2018 study of 20 years of California snakebite data. He found that snakebites decreased after periods of drought and increased after periods of heavy rain.

This past winter was the wettest on record in the U.S., with 9.01 inches of precipitation, 2.22 more than the average, according to the National Oceanic and Atmospheric Administration.

It is not completely clear why rain drives snake activity, Dr. Lipman said, but he theorizes that heavy rain causes flora and fauna to flourish, creating ready food sources for rodents who become food for snakes. Heavy rains can also drive snakes out of their habitats, according to Mr. Beane, the herpetologist.

To be sure, venomous snake bites are rare in the U.S. compared with other parts of the world. About 7,000 to 8,000 people in the U.S. are bitten each year and about five die, according to estimates by the Centers for Disease Control and Prevention. Most fatalities occur when a victim has an allergic reaction or is far from medical treatment when bitten, poison-control experts said.

It is difficult to get accurate data on the number of snake bites, which aren’t tracked by state or federal regulators. The state poison control centers, typically housed in medical centers, track snake encounters by incoming requests for help, particularly from medical professionals seeking help with antivenom dosing.

Mr. Beane and other herpetologists caution against identifying long-term trends from incomplete data sets collected over a relatively short period of time. He also said some people bitten by non-venomous snakes mistakenly report being bitten by copperheads.

To avoid being bitten, Mr. Beane said to clear away piles of leaves, wear shoes while outdoors and use a flashlight when out at night. He also said to leave snakes alone, because they typically won’t bother you unless you bother them.

Mr. Beane said he encourages the skittish to see the good in North Carolina’s abundant copperheads, from their “superb color and pattern” to their role in controlling the rodent and insect population.

“If not, I tell them to move to a place where they don’t occur, like a high-rise apartment,” he said.

Africa braced for snakebite crisis - via Herp Digest

Health specialists warn that stocks of antivenom will run out in 2016.

Nature, 17 September 2015

Rural Africa is facing a resurgence of a persistent plague that rarely makes headlines: snakebite.

By June next year, stockpiles of the anti-venom that is most effective against Africa’s vipers, mambas and cobras are expected to run out because the only company that makes the medicine has stopped production. With no adequate replacement in sight, the death toll from bites is set to rise, specialists warned at a tropical-medicine congress last week in Basel, Switzerland.

“We’re dealing with a neglected health crisis that is turning into a tragedy for Africa,” says Gabriel Alcoba, a medical adviser with the international humanitarian group Médecins Sans Frontières (MSF; also known as Doctors Without Borders).

Venomous snakes might seem an archaic menace in such a rapidly urbanizing world. Yet by cautious estimates, snakebites kill more than 100,000 people worldwide every year — more, on average, than lose their lives in natural disasters. And survivors often experience permanent physical and mental disabilities.

Death toll

It is uncertain how many people are bitten or die from snakebites in sub-Saharan Africa. But according to Médecins Sans Frontières (MSF; also known as Doctors Without Borders), whose health-care workers treat snakebites through field programmes in the Central African Republic and South Sudan, an estimated 30,000 people die each year and at least 8,000 more undergo amputations.

But snakebite mortality could be much higher than anecdotal reports suggest. For some countries, including the Democratic Republic of Congo — home to an enormous number of venomous snakes — there are no reliable data, says tropical-medicine specialist David Warrell at the University of Oxford, UK.

Under-reporting is not limited to Africa. The authors of a nationally representative snakebite-mortality survey, published in 2011, deduced that, despite the availability of antidotes, around 46,000 people in India die of snakebites every year (B. Mohapatra et al. PLoS Negl. Trop. Dis. 5, e1018; 2011). India’s Central Bureau of Health Intelligence reported merely 1,219 and 985 fatal bites for 2009 and 2010, respectively. One reason for the discrepancy, says Warrell, who co-authored the study, is that many victims of snakebites die before they reach a hospital, or waste precious time with traditional healers before seeking more-conventional medical help. Q.S.

More

In 2010, the French drug firm Sanofi Pasteur in Lyon ceased production of Fav-Afrique, an antibody serum that reduces the quantity of venom circulating in the blood of a snakebite victim. Made from the purified plasma of horses previously injected with small quantities of snake venom, the serum neutralizes the venom of many of Africa’s most dangerous snakes.

The antidote has saved many people from bites by deadly species such as the carpet viper (Echis ocellatus), common in West Africa, and the black mamba (Dendroaspis polylepis), found across the sub-Saharan region. But the high costs — US$250–500 per person — and a supply shortage mean that only about 10% of snakebite victims in Africa get treatment, and the company says that producing the antidote is no longer profitable. Cheaper products by competitors have forced Sanofi Pasteur out of the African market, says Alain Bernal, a company spokesman. Sanofi Pasteur is working to enable the transfer of know-how to companies willing to take over production of Fav-Afrique, he says.

Pharmaceutical companies in South Africa, India, Mexico and Costa Rica are among those marketing cheaper products — some of which work well against snakes in their host nations. But their safety and effectiveness against the large variety of species in Africa have not yet been established in clinical trials. To speed up the process, MSF is offering two of its hospitals in the Central African Republic (CAR) and South Sudan as study sites. But it will take at least two years to validate the products in development, and none is as broadly efficient as Fav-Afrique, Alcoba says.

Neglected threat

Although just now becoming critical, Africa’s snakebite problem has been smouldering for years, says tropical-medicine specialist David Warrell of the University of Oxford, UK, who consults for the World Health Organization (WHO). Snakebite fatalities have been rising over the past decade in the CAR, Ghana and Chad — in part owing to a failure to train enough medical staff, ignorance from health ministries and “unscrupulous marketing” of inappropriate antivenoms, he says. “War-torn countries have many other problems. But the millions of children, poor farmers and nomadic people at risk of snakebites just don’t have the ear of politicians in capital cities.”

And according to Warrell, the WHO has done little to help. To improve the safety and efficacy of antibodies, the agency has released guidelines for producing antivenoms. But it has no formal programme for improving treatment by training medical workers, advising ministries or educating communities, as it does for 17 otherneglected tropical diseases, including dengue and sleeping sickness. And yet, says Warrell, snakebites cause more deaths than do all 17 diseases put together.

Warrell says that, while waiting for clinical trials to bring replacements for Fav-Afrique to the market, the keys to reducing the risk of snakebite are education and preventive measures — such as wearing proper shoes, using a light when walking home from the fields and sleeping above ground level, beneath a mosquito net.

Thankfully, says Alcoba, the global-health community is starting to grasp the urgency of the situation. “People used to laugh when we talked about snakebites,” he says. “They don’t laugh anymore.

Snakebites in Costa Rica Rise Along with El Niño Cycles

by Stephanie Pappas, Live Science Contributor | September 11, 2015 02:06pm ET

In Costa Rica, El Niño has a strange side effect: More snakebites.

Both the hot and cold phases of the El Niño Southern Oscillation (known as El Niño and La Niña, respectively) are accompanied by an increase in snakebites in the Central American country, according to a new study published today (Sept. 11) in the journal Science Advances. Here's how the climate cycle might be tied to slithering creatures:Snakes are ectothermic, meaning they get their body heat from outside sources. That means their activity is sensitive to climatological factors.

"Snakebites, probably the most neglected of the neglected tropical diseases, [are] another disease showing changes in [the] face of climate change," study researcher Luis Fernando Chaves, a scientist at the Institute of Tropical Medicine at Nagasaki University in Japan, told Live Science.

Continued ...

Inssssane! Man CHOOSES to be bitten by venomous snakes

MEET the brave bloke who LETS poisonous snakes bite him and sink their venom into his body.

Tim Friede, 45, has survived over 100 bites from poisonous snakes after he built up his immunity by injecting himself with diluted venom.

Now he is only too happy to let a snake bite him on the arm and then sit back and let the pain subside.

Many would question why Tim, whose arm balloons in size due to the poison beringing about a potentially fatal allergic reaction, would want to do this, but he insists he has a good reason.

The jobless factory worker says he want to prove that millions of people who are at risk from snake bites could be made immune if they followed his lead.

He said: "I hope through developing my own resistance to poison some solid groundwork can be laid to build a vaccine for the 125,000 people who die from snakebites every year.

Continued

Rattlesnake bites customer in Wal-Mart

A Wal-Mart customer is recovering after he was bitten by a rattlesnake in a garden department of the store chain.

Mica Craig said the reptile pounced as he was shopping at the store in the north-western US state of Washington.

The 47-year-old stamped on the serpent and was later treated at hospital with anti-venom, after his hand suffered serious swelling.

Wal-Mart apologised, and said it was investigating how the snake had entered the store in the city of Clarkston.

Kayla Whaling, a spokeswoman for the chain, said: "At this point, it appears to be an isolated incident.

"We are working with a pest management team, which is conducting a sweep of the property to ensure there is no additional rattlesnake activity."

Another customer, Maria Geffre, told Reuters news agency the snake was at least 1ft (30cm) long with four rattles.

Mr Craig said the serpent attacked as he reached down to brush away what he thought was a stick from a bag of mulch.

The purchase was intended for his marijuana plants, which Mr Craig said he was licensed to grow for medical reasons.

http://www.bbc.co.uk/news/world-us-canada-18067653

Why is the land of snakes, so inept at dealing with snake bites? (via Herp Digest)

The number of people who died of snakebite in India was not known for decades. But there was no doubt thousands perished. This was, after all, the proverbial land of snakes. Finally, in April last year, a study estimated about a million people were bitten by snakes and approximately 46,000 died annually. These first reliable figures illustrate the enormity of the problem rural people face in this country. We also know more people are killed by snakes in India than any other country in the world.

Snakebite is a major occupational hazard in a country where farmers typically walk barefoot along field bunds. While we can exhort them to wear footwear, it will take years for this long-observed practice to change. People also tend to walk in the dark without a torch. For several decades, the price of disposable batteries was prohibitive for ordinary villagers, but the use of the new, affordable Chinese-made rechargeable torches may reduce the death toll. The other habit that puts rural people in harm's way is sleeping on the floor. When farm economy is floundering, advising them to sleep on bedsteads will only elicit blank, uncomprehending stares. If people get bitten and are rushed to the hospital, the lack of doctors, trained in treating snakebite, as well as the limited availability and effectiveness of antivenom serum, jeopardize their lives further.

The only way to save a person from a lethal venomous snakebite is the administration of antivenom serum, even though too many people rely on superstition and alternative forms of medicine. Indians have had a surefire way of surviving a lethal bite as early as the 1920s, when the Central Research Institute began producing this life-saving drug commercially. Yet, almost a century later, despite snakebite continuing to be a major public health crisis, the availability of antivenom serum in small towns and villages, where bites usually occur, is limited.

Six manufacturers produce a serum made from the venoms of the Big Four: cobra, common krait, Russell's viper and saw-scaled viper. Despite advances in antivenom production techniques, those of the Indian companies remain relatively unchanged since the 1950s. Several international publications have criticized Indian antivenoms for their impurity and for causing complicating side effects.

All the companies claim identical potency for their antivenom serums, which is astonishingly low. This means many more vials are needed to neutralize the harmful effects of a venomous snakebite. One study says a person needs an average of 51 vials to treat cobra and krait bite, while 32 vials are needed to treat Russell's viper bite. Another study quoted as much as 91 vials being used to neutralize cobra and krait bites. Such high doses of impure antivenom serum can potentially cause adverse reactions. In Sri Lanka, up to 87% of snakebite victims who were treated with Indian antivenom developed untoward side effects.

A standard clinical procedure to validate the claimed potency values has never been published. Inexplicably, prior to the mid-1950s, antivenom serums were much more potent than those currently available. It's not clear why the Indian authorities lowered the standards.

The low potency and high adverse reactions have raised doubts about the effectiveness of Indian antivenom serum. Venom is a protein-rich soup with numerous toxins, peptides and enzymes. What snakes eat determines the combination and proportion of these elements in their venom. In many species, the venom of young snakes, which eat small creatures like frogs, undergoes a transformation as they grow older and switch to eating larger animals like rodents. Where they live also appears to influence the kind of venom they produce, even within a species. For instance, the venom of Russell's vipers in south India is quite different from the north. So antivenom made with the venom of a southern viper may not work against the same species in other parts of the country.

Indian antivenom is produced for four snakes against the World Health Organization's (WHO) list of twelve high-priority species for South Asia. In short, we do not know what coverage the antivenom serum has. Does it neutralize the bites caused by the young of the same species, and is it as effective anywhere in the country. Does the serum made for the Big Four counteract the venom of any others? In the absence of these tests, physicians have no choice but to try and save the lives of their patients with the only tool they have.

In 2010, WHO recommended a set of standard procedures for the assessment and evaluation of antivenoms anywhere in the world. David Williams, a clinical toxinologist working with the Global Snakebite Initiative, says Indian antivenom has to be tested for effectiveness against the high-priority snake species. Only then can doctors be sure that the treatment they are providing their patients, which is often expensive and beyond poor people's means (between Rs. 450 and 500 a vial), is effective.

Williams further advises that once the lack of effectiveness of the available antivenom serum is established, if the problem cannot be fixed easily, then a new start has to be made to produce a broad-spectrum antidote for the entire region. Several manufacturers should be licensed to produce this life-saving drug. Antivenom should be distributed free or at heavily subsidized rates through the public health system. In Tanzania, people sought antivenom treatment much more readily when it was provided free, which indicates their reliance on traditional medicine and superstition is at least partly driven by cost considerations.

Indian health authorities must recognize snakebite for what it is: a neglected tropical disease that maims and kills tens of thousands of poor people. While the WHO acknowledged this fact in 2009, snakebite is yet to feature in any of the organization's programs. Besides the development of an effective antivenom serum and training doctors, a major awareness campaign needs to be launched to teach people to avoid being bitten by snakes, as well as the appropriate first-aid practices to follow in the event of a bite. India has to overcome poor governance, abysmal regulation of antivenom quality, and social inequity to arrest the unconscionable loss of lives to snakebite